Nakamura Yuki, Okubo Mitsuo, Furuta Yoshiaki, Tokida Miho, Ichikawa Kayoko, Ohsaka Akimichi
Department of Transfusion Service, Juntendo University Hospital, Tokyo, Japan.
Department of Transfusion Service, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Transfus Apher Sci. 2019 Dec;58(6):102664. doi: 10.1016/j.transci.2019.10.006. Epub 2019 Nov 10.
Over the past decade, there have been two major advancements in autologous peripheral blood stem cell (PBSC) collection, namely enumeration of CD 34+ cells for apheresis prediction and use of plerixafor to assist mobilization of PBSC. This study aimed to investigate changes in the efficacy of PBSC collection from two Japanese university hospitals over an eight-year period.
A series of 399 PBSC collection procedures from 239 patients with solid malignant tumors (ST, n = 42), malignant lymphoma (ML, n = 91), multiple myeloma (MM, n = 99), and others (amyloidosis and leukemia, n = 7) from two university hospitals from 2011 to 2018 were retrospectively analyzed. We also analyzed the effects of CD34+ pre-counting and plerixafor administration in improving CD34+ cell yield.
Using CD34+ pre-count as a reference, the frequency of apheresis was reduced and the yield of CD34+ cells increased in patients with ST. When administrating plerixafor, especially with a CD34+ pre-count <20/μL, the yield of CD34+ cells was significantly increased in patients with ML (p = 0.02) and MM (p = 0.03).
We verified that CD34+ cell counting and plerixafor administration contributed to effective PBSC collections in our hospitals for the eight-year study period. In patients with ST, CD34+ pre-count threshold for starting apheresis was ≥10/μL. CD34+ pre-count (<20/μL) was useful to select appropriate patients for plerixafor administration among the patients with ML and MM.
在过去十年中，自体外周血干细胞（PBSC）采集有两项重大进展，即通过计数CD 34+细胞来预测单采以及使用普乐沙福辅助PBSC动员。本研究旨在调查八年间两家日本大学医院PBSC采集效果的变化。
对2011年至2018年期间来自两家大学医院的239例实体恶性肿瘤（ST，n = 42）、恶性淋巴瘤（ML，n = 91）、多发性骨髓瘤（MM，n = 99）及其他疾病（淀粉样变性和白血病，n = 7）患者的399次PBSC采集程序进行回顾性分析。我们还分析了CD34+预计数和普乐沙福给药对提高CD34+细胞产量的影响。
以CD34+预计数为参考，ST患者的单采频率降低，CD34+细胞产量增加。在使用普乐沙福时，尤其是CD34+预计数<20/μL时，ML患者（p = 0.02）和MM患者（p = 0.03）的CD34+细胞产量显著增加。
我们证实，在为期八年的研究期间，CD34+细胞计数和普乐沙福给药有助于我们医院进行有效的PBSC采集。对于ST患者，开始单采的CD34+预计数阈值为≥10/μL。CD34+预计数（<20/μL）有助于在ML和MM患者中选择适合使用普乐沙福的患者。
